CN110507457A - A kind of bracket, its transportation system and medical instrument - Google Patents
A kind of bracket, its transportation system and medical instrument Download PDFInfo
- Publication number
- CN110507457A CN110507457A CN201910816613.5A CN201910816613A CN110507457A CN 110507457 A CN110507457 A CN 110507457A CN 201910816613 A CN201910816613 A CN 201910816613A CN 110507457 A CN110507457 A CN 110507457A
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- China
- Prior art keywords
- stent
- bracket
- inner stent
- internal layer
- middle tube
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/94—Stents retaining their form, i.e. not being deformable, after placement in the predetermined place
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
Abstract
This application discloses a kind of brackets, it include: inner stent (1), the outer stent (2) being set on the outside of the inner stent (1), the inner stent (1) and outer stent (2) respectively include head end, tail end, and the interlude between head end and tail end；The head end of the inner stent (1) is fixedly connected with the outer stent (2), is formed bracket junction (3)；The inner stent (1) from it is swollen to blood vessel diameter when metal coverage rate > 15%, when the outer stent (2) self-expands into blood vessel diameter, when by axial force, the change rate < 15% of the axial each segment diameter of bracket.The application also provides transportation system, medical instrument.Transportation system provided by the present application, medical instrument, the high inner stent of the metal coverage rate outer stent strong with radial non-deformability is set, blood flow can be changed simultaneously providing good support force, be suitable for aneurysm, be particularly suitable for wide neck aneurysm, netraneurysm.
Description
Technical field
This application involves the field of medical instrument technology, more particularly to a kind of bracket, its transportation system and medical instrument.
Background technique
Intracranial aneurysm is apt to occur in 40-70 years old adult, and the complication of most serious is to intracranial hemorrhage, such as cavum subarachnoidale
Bleeding, intraventricular hemorrhage, intracerebral hematoma etc.；Wherein with spontaneous subarachnoid hemorrhage (subarachnoid
Hemorrhage, SAH) it is most commonly seen.It is investigated according to epidemiology statistics, the disease incidence of China's subarachnoid hemorrhage is annual 5-
20/100000 people, wherein 34% is caused by aneurysm rupture, and in the case of aneurysm rupture, netraneurysm and wide arteria carotis
Tumor accounts for 1-4%.
The existing aneurysmal instrument for the treatment of, 1. bracket secondary spring circle embolisms, overlay film frame: is used for wide neck aneurysm and shuttle
There is perforating artery blood vessel at shape aneurysm, the blood supply of perforating artery cannot be effectively maintained；2. close mesh stent is in shuttle shape artery
In the therapeutic process of tumor and epimegetic wide neck aneurysm, operation difficulty is big, be easy the bracket to be positioned to shuttle shape or bracket protrude into it is dynamic
Inside arteries and veins knurl, the performance that branch puts up tubulose is poor, and therapeutic effect is poor, it is difficult to meet clinical demand.
Therefore, how a kind of bracket is provided, in the treatment of netraneurysm and wide neck aneurysm, it is dynamic to retain perforating branches in tumor
The blood supply of arteries and veins improves bracket in the endovascular molding effect of knurl, and accurate positioning reduces the operation requirement of patient, is this field
Technical staff's technical problem urgently to be resolved.
Summary of the invention
In order to solve the above technical problems, it is an object of the present invention to provide a kind of brackets；Second object of the present invention is to mention
For a kind of transportation system for conveying above-mentioned bracket；Third object of the present invention is to provide one kind to include above-mentioned bracket and delivery system
The medical instrument of system.Bracket provided by the present application passes through the setting higher inner stent of metal coverage rate and radial resistance to deformation energy
The strong outer stent of power can change simultaneously blood flow providing good support force, be suitable for aneurysm, be particularly suitable for wide neck
Aneurysm, netraneurysm.
Technical solution provided by the invention is as follows:
A kind of bracket, comprising: inner stent, the outer stent being set on the outside of the inner stent, the inner stent
Head end, tail end are respectively included with outer stent, and the interlude between head end and tail end；
The head end of the inner stent is fixedly connected with the outer stent, forms bracket junction；
The inner stent from it is swollen to blood vessel diameter when metal coverage rate > 15%, the outer stent self-expands into blood
When pipe diameter, when by axial force, the change rate < 15% of the axial each segment diameter of bracket.
Preferably, the bracket junction is located at the head end of the outer stent, or positioned at the centre of the outer stent
Section.
Preferably, the bracket junction is specially the loop connecting circle around the inner stent periphery, or for around described
At least two linkage sections of inner stent periphery.
Preferably, the diameter of the head end of the outer stent and/or tail end is straight greater than the outer stent interlude
Diameter.
Preferably, the different parts metal coverage rate of the inner stent is different.
Preferably, the inner stent is from swollen braided support, and the outer stent is from swollen engraving bracket or certainly
Swollen braided support.
A kind of transportation system, for conveying bracket described in any of the above embodiments, comprising: internal layer guiding piece is set in described
Middle tube on the outside of internal layer guiding piece, and the outer tube being set on the outside of the middle tube；
The inner stent is loaded between the internal layer guiding piece and the middle tube, and the outer stent is loaded in institute
It states between middle tube and the outer tube；
The internal layer guiding piece is located at the inner stent tail end, for stopping the movement of the inner stent or described
Internal layer guiding piece outer wall is equipped with the first block piece, and first block piece is located at the inner stent tail end, described for stopping
The movement of inner stent；
The middle layer pipe outer wall is equipped with the second block piece, and second block piece is located at the outer stent tail end, is used for
Stop the movement of the outer stent.
Preferably, the front end of the middle tube, concordant with the tail end of the outer stent, second block piece is located at institute
State the front end of middle tube；The outer tube is located at one section of reduced diameter before the middle tube.
Preferably, the internal layer guiding piece is conduit or seal wire；And/or
The outer tube includes loading pipe and delivery conduit.
A kind of medical instrument, is made of bracket and transportation system, and the bracket is bracket described in any of the above embodiments, described
Transportation system is transportation system described in any of the above embodiments.
In view of the problems of the existing technology, the application provides a kind of bracket, by setting from it is swollen to blood vessel diameter when gold
Belong to the inner stent of coverage rate > 15%, preferably > 20%, more preferable > 30%, more preferable > 40%, further preferably > 45%, and
When self-expanding into blood vessel diameter, when by axial force, the change rate < 15%, preferably < of the axial each segment diameter of bracket
10%, more preferable 8%, the outer stent of more preferable < 6%, further preferably < 5%, and make the head end and outer stent of inner stent
It is fixedly connected, the support performance of outer stent is good, can provide good support force, and processability is preferable in the blood vessels, release
Generally can be formed in the blood vessels uniform cylindric, realize that the strong outer stent of outer layer radial direction non-deformability plays and supports work
With；The big inner stent of inner layer metal coverage rate plays the role of changing blood flow simultaneously, to realize in wide neck aneurysm or shuttle
Discharge indeformable in shape aneurysm, precisely release is to target position, avoids blood from directly impacting blood vessel by changing blood supply and causes
Aneurysm rupture；Meanwhile lesser grid can guarantee that blood flow passes through, so that being suitable for netraneurysm has perforating artery blood vessel
The case where retaining is needed, provides part-blood-supplied for perforating artery.
Detailed description of the invention
In order to illustrate the technical solutions in the embodiments of the present application or in the prior art more clearly, to embodiment or will show below
There is attached drawing needed in technical description to be briefly described, it should be apparent that, the accompanying drawings in the following description is only this
The some embodiments recorded in application, for those of ordinary skill in the art, without creative efforts,
It is also possible to obtain other drawings based on these drawings.
Fig. 1 is the structural schematic diagram of bracket in the embodiment of the present invention 1；
Fig. 2 is that bracket is located at the schematic diagram at netraneurysm in the embodiment of the present invention 1；
Fig. 3 is the planar development schematic diagram of outer stent in bracket in the embodiment of the present invention 1；
Fig. 4 is the planar development schematic diagram of inner stent in bracket in the embodiment of the present invention 1；
Fig. 5 is the structural schematic diagram of bracket in the embodiment of the present invention 2；
Fig. 6 is that bracket is located at the schematic diagram at netraneurysm in the embodiment of the present invention 2；
Fig. 7 is medical apparatus structure schematic diagram in the embodiment of the present invention 4；
Fig. 8 is medical instrument part A enlarged diagram in the embodiment of the present invention 4；
Fig. 9 is medical instrument part B enlarged diagram in the embodiment of the present invention 4；
Figure 10 is medical instrument C portion enlarged diagram in the embodiment of the present invention 4；
Figure 11 is medical instrument using process diagram in the embodiment of the present invention 4；Wherein, step a is described for that will be mounted with
The transportation system of bracket is sent into patient's body target position；Step b is recession outer tube, and keeps the middle tube and described
Internal layer guiding piece position is constant, and outer stent gradually discharges；Step c is that outer stent all discharges；Step d is recession middle layer
Pipe, is pushed forward the internal layer guiding piece, inner stent gradually discharges；Step e is that inner stent all discharges；
Figure 12 is medical apparatus structure schematic diagram in the embodiment of the present invention 5；
Figure 13 is medical instrument D enlarged schematic partial view in the embodiment of the present invention 5；
Figure 14 is medical instrument E enlarged schematic partial view in the embodiment of the present invention 5；
Figure 15 is medical instrument F enlarged schematic partial view in the embodiment of the present invention 5；
Figure 16 is medical instrument using process diagram in the embodiment of the present invention 5；Wherein, step a is described for that will be mounted with
The transportation system of bracket is sent into patient's body target position；Step b is recession outer tube, and keeps the middle tube and described
Internal layer guiding piece position is constant, and outer stent gradually discharges；Step c is that outer stent all discharges；Step d is recession middle layer
Pipe, is pushed forward the internal layer guiding piece, inner stent gradually discharges；Step e is that inner stent all discharges；
Figure 17 is medical apparatus structure schematic diagram in the embodiment of the present invention 6；
Figure 18 is medical instrument G enlarged schematic partial view in the embodiment of the present invention 6；
Figure 19 is medical instrument H enlarged schematic partial view in the embodiment of the present invention 6；
Figure 20 is medical instrument I enlarged schematic partial view in the embodiment of the present invention 6；
Figure 21 is medical instrument using process diagram in the embodiment of the present invention 6；Wherein, step a is described for that will be mounted with
The transportation system of bracket is sent into delivery conduit；Step b is after removing outer tube, and bracket is sent into patient's body mesh along delivery conduit
Cursor position；Step c is the support schematic diagram before release；Step d is recession delivery conduit, and keeps the middle tube and described
Internal layer guiding piece position is constant, and outer stent gradually discharges；Step e is that outer stent all discharges；Step f is recession middle layer
Pipe, is pushed forward the internal layer guiding piece, inner stent gradually discharges；Step g is that inner stent all discharges；
Figure 22 be can be used as in the embodiment of the present invention outer stent from swollen braided support exemplary diagram；
Appended drawing reference: 1- inner stent；2- outer stent；3- bracket junction；4- internal layer guiding piece；41- first stops
Part；5- middle tube；The second block piece of 51-；6- outer tube.
Specific embodiment
In order to make those skilled in the art better understand the technical solutions in the application, below in conjunction with the application reality
The attached drawing in example is applied, the technical scheme in the embodiment of the application is clearly and completely described, it is clear that described implementation
Example is merely a part but not all of the embodiments of the present application.Based on the embodiment in the application, this field is common
The application protection all should belong in technical staff's every other embodiment obtained without making creative work
Range.
It should be noted that it can directly exist when element is referred to as on " being fixed on " or " being set to " another element
On another element or indirectly setting on the other element；When an element is known as " being connected to " another element,
It can be directly to another element or be indirectly connected on another element.
It is to be appreciated that term " length ", " width ", "upper", under ", "front", "rear", "left", "right", "vertical",
The orientation or positional relationship of the instructions such as "horizontal", "top", "bottom" "inner", "outside" is that orientation based on the figure or position are closed
System is merely for convenience of description the application and simplifies description, rather than the device or element of indication or suggestion meaning must have
Specific orientation is constructed and operated in a specific orientation, therefore should not be understood as the limitation to the application.
In addition, term " first ", " second " are used for descriptive purposes only and cannot be understood as indicating or suggesting relative importance
Or implicitly indicate the quantity of indicated technical characteristic.Define " first " as a result, the feature of " second " can be expressed or
Implicitly include one or more of the features.It is multiple in the description of the present application ", " several " be meant that two or
Two or more, unless otherwise specifically defined.
It should be clear that structure depicted in this specification attached drawing, ratio, size etc., only to cooperate specification revealed
Content is not limited to the enforceable qualifications of the application, therefore does not have so that those skilled in the art understands and reads
Technical essential meaning, the modification of any structure, the change of proportionate relationship or the adjustment of size are not influencing the application institute energy
Under the effect of generation and the purpose that can reach, it should all still fall in techniques disclosed in this application content and obtain the range that can cover
It is interior.
The embodiment of the present application is write in a progressive manner.
Please as shown in Fig. 1 to Figure 22, the embodiment of the present invention provides a kind of bracket, comprising: inner stent 1 is set in described
The outer stent 2 in 1 outside of inner stent, the inner stent 1 and outer stent 2 respectively include head end, tail end, and are located at head end
Interlude between tail end；
The head end of the inner stent 1 is fixedly connected with the outer stent 2, forms bracket junction 3；
The inner stent 1 self-expands into the metal coverage rate > 15% when blood vessel diameter, 2 self-expanding of outer stent
When to blood vessel diameter, when by axial force, the change rate < 15% of the axial each segment diameter of bracket.
The existing aneurysmal instrument for the treatment of, it is difficult to suitable for having perforating artery blood vessel at wide neck aneurysm and netraneurysm
Need the case where retaining.When facing wide neck aneurysm, using Coil embolization, spring ring is easily run out of out of tumor.Use bracket
Secondary spring circle embolism, it is complicated for operation, for the more demanding of patient although can be used for wide neck aneurysm.In addition, close
Mesh stent can be bent or be expanded into tumor, it is also difficult to be suitable for wide neck aneurysm due to easily-deformable.When in face of netraneurysm
It is equal using Coil embolization, bracket secondary spring circle embolism, overlay film frame when place has perforating artery blood vessel to need the case where retaining
Be difficult to retain branch vessel, though and close mesh stent can retain part blood flow, since its support performance is poor, there are still mutabilities
Shape can be bent or expand into tumor, be easy the problem of bracket is discharged into shuttle shape or cryptomere, and close mesh stent needs are being dropped back
While outer tube, inner tube or silk are pushed, or even needs whole push-and-pull transportation system, to guarantee bracket release at uniform circle
Post shapes, release positioning is more demanding for patient, and releasing effect is unsatisfactory.
In view of the problems of the existing technology, the application provides a kind of bracket, passes through setting metal coverage rate > 15%, excellent
The inner stent 1 of > 20%, more preferable > 30%, more preferable > 40%, further preferably > 45% are selected, and self-expands into blood vessel diameter
When, when by axial force, the change rate < 15%, preferably < 10% of the axial each segment diameter of bracket, more preferable 8%, more excellent
The outer stent 2 of < 6%, further preferably < 5% are selected, and is fixedly connected with the head end of inner stent 1 with outer stent 2, outer layer branch
The support performance of frame 2 is good, can provide good support force, and processability is preferable in the blood vessels, discharges general energy in the blood vessels
Formation is uniform cylindric, realizes that the strong outer stent 2 of outer layer radial direction non-deformability is played a supporting role, while inner layer metal
The big inner stent 1 of coverage rate plays the role of changing blood flow, discharges in wide neck aneurysm or netraneurysm to realize
Indeformable, precisely release to target position avoids blood from directly impacting blood vessel and causes aneurysm rupture by change blood supply；Together
When, lesser grid can guarantee that blood flow passes through, to be suitable for the feelings that netraneurysm has perforating artery blood vessel to need to retain
Condition provides part-blood-supplied for perforating artery.
In the application, axial compressive force is different and different according to the form of bracket,
Bracket provided by the present application in use, fix after outer stent 2 discharges by position, can make the company of being secured to
The position of the inner stent 1 connect is fixed.Since outer stent 2 needs radial non-deformability strong, cripetura is worth small (cripetura
Value=bracket is loaded in the length in the outer tube-length of bracket release in the blood vessels), therefore, outer stent 2 is in release process
In be easy positioning, the operation of patient is required lower；And the head end and outer stent 2 of the big inner stent 1 of cripetura value fixed connect
It connects, the position of inner stent 1 can be fixed after 2 accurate positioning of outer stent, conducive to the release of entire bracket in vivo, reduce art
Person's operation difficulty improves success rate of operation.
Preferably, the bracket junction 3 is located at the head end of the outer stent 2, or in the outer stent 2
Between section.
Preferably, the bracket junction 3 is specially the loop connecting circle around 1 periphery of inner stent, or for around institute
State at least two linkage sections of 1 periphery of inner stent.
In the application, bracket junction 3 (i.e. the junction of the head end of inner stent 1 and outer stent 2) is located at outer layer branch
The head end of frame 2, or the interlude positioned at layer bracket 2.That is, the head end of inner stent 1 and the head end of outer stent 2 can be generally flush with
, the head end for being also possible to inner stent 1 is located at the interlude of outer stent 2, as long as inner stent 1 has part and outer stent
2 overlappings can play the role of support simultaneously and change blood flow.
Bracket junction 3 can be the loop connecting circle around 1 periphery of inner stent, i.e. the head end of inner stent 1 is whole
Circle is fixedly connected with outer stent 2；Bracket junction 3 is also possible at least two linkage sections around 1 periphery of inner stent,
I.e. the head end of inner stent 1 is at least connected in two linkage sections with outer stent 2.Linkage section can be the company with certain length
Place is met, can also be tie point.Guarantee safely, do not fall off in the case where, the form and quantity of bracket junction 3 can arbitrarily become
Change.
Preferably, the diameter of the head end of the outer stent 2 and/or tail end is straight greater than 2 interlude of the outer stent
Diameter.
In the application, the preferred diameter of the head end of outer stent 2 and/or tail end, greater than 2 interlude of outer stent
Diameter.That is, the head end and/or tail end of outer stent 2 are expanded compared with interlude.The head end and tail end of more preferable outer stent 2 are simultaneously
It is expanded compared with interlude, forms the bracket of dumb-bell shape.At this point, the head end of inner stent 1 and 2 interlude of outer stent do not expand place
It is fixedly connected, then the both ends support that outer stent 2 expands in the blood vessel, is conducive to blood flow and passes through, and further increasing is branch's blood
The amount for the blood flow that pipe provides, ensure that the blood supply of perforating artery in tumor.
As needed, it can also only be arranged in one end of outer stent 2 and expand position, blood supply stream passes through.
Preferably, the different parts metal coverage rate of the inner stent 1 is different.
Further, it can also be designed to variations for the metal coverage rate of inner stent 1, that is, in the bracket after expansion, internal layer
The metal coverage rate of 1 partial region of bracket, it is different from the metal coverage rate in another region.The difference of metal coverage rate is usually by changing
Become mesh diameter, or changes the ratio of mesh occupied area and supporting structure (such as wire) occupied area to realize.To this
The bracket that application provides can be customized according to the case where patient, so that smaller (the i.e. mesh of the metal coverage rate of inner stent 1
Larger part, but metal coverage rate herein is still greater than the metal coverage rate of outer stent 2) opposite at the branch vessel of patient
It answers, to ensure branch vessel blood supply, and remaining position of inner stent 1 maintains metal coverage rate big, to change blood flow.
Preferably, the inner stent 1 be from swollen braided support, the outer stent 2 be from swollen engraving bracket or
From swollen braided support.
In the application, preferably inner stent 1 is usually to be woven from swollen braided support by titanium-nickel wire, it is possible to use
Other common used materials are knitted to form.The mesh of braided support is smaller, and metal coverage rate is big, can effectively change blood flow, but cripetura
It is worth larger, cripetura value the greater even > 100%, independent release is more demanding to the operation of patient；It but is by it in the application
It is fixedly connected with outer stent 2, by controlling the positioning and release of outer stent 2, braided support positioning and release can be mitigated
Difficulty.Outer stent 2 is from swollen engraving bracket or from swollen braided support, from swollen engraving bracket usually by laser simultaneously
It carves and is made on NiTi pipe, it is possible to use other methods are carved.The cripetura for carving bracket is worth small, support performance
Good, the braided support that cooperation changes blood flow uses, and can be effectively improved bracket molding effect in tumor, and can retain tumor on demand
The blood supply of interior perforating artery.It is different according to the mode of braiding from swollen braided support, excellent support power can also be provided.For example,
As shown in figure 22, it is interconnected to constitute braided support using the braided material of sectional type, since each segment is capable of providing radial direction
The holding capacity of support force, therefore when by axial force, each segment of bracket shape in a circumferential direction is preferable；And between segment
With gap, part power can be absorbed when by axial force, reduce each segment diameter variation of bracket, to can also be used as outer layer
Bracket 2 uses.
A kind of transportation system, for conveying bracket described in any of the above embodiments, comprising: internal layer guiding piece 4 is set in described
The middle tube 5 in 4 outside of internal layer guiding piece, and it is set in the outer tube 6 in 5 outside of middle tube；
The inner stent 1 is loaded between the internal layer guiding piece 4 and the middle tube 5, and the outer stent 2 loads
Between the middle tube 5 and the outer tube 6；
The internal layer guiding piece 4 is located at 1 tail end of inner stent, for stopping movement or the institute of the inner stent 1
4 outer wall of internal layer guiding piece is stated equipped with the first block piece 41, first block piece 41 is located at 1 tail end of inner stent, is used for
Stop the movement of the inner stent 1；
5 outer wall of middle tube is equipped with the second block piece 51, and second block piece 51 is located at 2 tail of outer stent
End, for stopping the movement of the outer stent 2.
The application also provides a kind of transportation system, cooperates bracket provided by the present application to use, to guarantee that bracket smoothly reaches
Patient's body target position, and can smoothly discharge.Specifically, transportation system provided by the present application, setting internal layer guiding piece 4,
Middle tube 5, outer tube 6 are formed between internal layer guiding piece 4 and middle tube 5, two interlayers between middle tube 5 and outer tube 6, point
Inner stent 1 and outer stent 2 Yong Yu not be loaded, so that bracket is wrapped among outer tube 6, is entering target location processes
In will not damage blood vessel or be hindered；Meanwhile internal layer guiding piece 4 itself or 4 outer wall of internal layer guiding piece are equipped with the first block piece
41,5 outer wall of middle tube is equipped with the second block piece 51, is respectively used to resist inner stent 1, outer stent 2 during release, keep away
Exempt from bracket and drop back as the tube body on the outside of it is dropped back, influences releasing effect.When resisting inner stent 1 using internal layer guiding piece 4
When, the distal tip of internal layer guiding piece 4 is located at 1 tail end of inner stent, internal layer guiding piece 4 can be realized, inner stent 1 is hindered
Gear effect, as shown in Figure 17 and Figure 20.Meanwhile when discharging inner stent 1, it can be also pushed forward internal layer guiding piece 4, make inner stent
1 releasing position is more accurate.
Preferably, the front end of the middle tube 5, second block piece 51 concordant with the tail end of the outer stent 2
In the front end of the middle tube 5；The outer tube 6 is located at one section of reduced diameter before the middle tube 5.
It is preferred that the front end of middle tube 5, concordant with the tail end of the outer stent 2, the second block piece 51 is located at described at this time
The front end of middle tube 5.That is, the position of middle tube 5, it is only necessary to guarantee that the second block piece 51 can resist outer stent 2, portion
The release of bracket will not be had an impact by dividing inner stent 1 to be directly abutted against outer stent 2, therefore middle tube 5 is outer without projecting forwardly to
The position of layer 2 head end of bracket.Theoretically, whole inner stents 1 are directly abutted against outer stent 2 and can also be used, but due to internal layer branch
The cripetura value of frame 1 is big, in order to guarantee the length meet demand of the inner stent 1 after release, the internal layer being loaded in transportation system
The length of bracket 1 is often longer than the length of outer stent 2, and middle tube 5 needs that the second block piece 51 is allow to resist outer layer branch
Frame 2, therefore, middle tube 5 can still wrap the inner stent 1 of part.Be designed in this way, then outer tube 6 its front end, it is internal without
One section of (i.e. 6 forward end apex of outer tube to one section of reduced diameter between the second block piece 51, to reduce entire of middle tube 5
The outer diameter of support system, conducive to transportation system patient's body traveling.
Preferably, the internal layer guiding piece 4 is conduit or seal wire；And/or
The outer tube 6 includes loading pipe and delivery conduit.
Internal layer guiding piece 4 can be conduit or seal wire.When internal layer guiding piece 4 is conduit, can will be penetrated in conduit
Seal wire, entire transportation system cooperation seal wire enter patient's body target position.When internal layer guiding piece 4 is seal wire, need in
Layer pipe 5,6 synchronizing moving of outer tube, at this point, entire transportation system enters patient's body target in the case where no seal wire guides
Position.
Outer tube 6 is wrapped in bracket outermost, so that loading good bracket will not damage before being conveyed into patient's body
Or it is contaminated.In the first embodiment, outer tube 6 can be an entirety, move together with middle tube 5, internal layer guiding piece 4
To patient's body target position.And as second of embodiment, it includes loading pipe and delivery conduit that outer tube 6, which is arranged, is loaded
Pipe is for loading bracket, and delivery conduit is used for bracket in the conveying of patient's body.Specifically, loading pipe cooperation middle tube 5,
Internal layer guiding piece 4 loads the bracket in tensional state wherein, loads pipe and plays fixed outer layer bracket 2 and avoid the external world
The effect of environment influence bracket.And delivery conduit has been sent under the guidance of seal wire in advance to patient's body target position, at this point, will
It is loaded in the bracket loaded in pipe and is sent into delivery conduit, loading pipe is then withdrawn from, so that bracket, middle tube 5, internal layer guiding piece 4
Target position is moved in delivery conduit as a whole, due to delivery conduit at this time do not need with bracket synchronizing moving,
But play the role of package and guiding in stent outer, it can be further reduced the diameter of delivery conduit, so that entire conveying
Space needed for process reduces, and is more suitable for requiring stringent lesion region to use size in intracranial vessel etc..Use conveying
Conduit and the operating process for loading pipe are as shown in figure 21.
Second of embodiment can reduce the diameter of delivery conduit, related with clinical manipulation: general conduit or delivery system
When system enters human vas, particularly encephalic thinner blood vessel, seal wire guiding is required.Therefore, defeated in the first embodiment
The internal layer guiding piece 4 for sending system is mostly pipe, need to reserve a guidewire lumen, therefore outer tube is relatively large sized.And second
Delivery conduit can be directed into lesions position through seal wire in advance in kind embodiment, and after withdrawing from seal wire, loaded device is sent into middle layer
Pipe 5 and internal layer guiding piece 4, internal layer guiding piece 4 can be filiform at this time, can save size, and the size that delivery conduit requires reduces.
A kind of medical instrument, is made of bracket and transportation system, and the bracket is bracket described in any of the above embodiments, described
Transportation system is transportation system described in any of the above embodiments.
Above-mentioned medical instrument provided by the present application, can use as follows:
The transportation system for being mounted with the bracket is sent into patient's body target position；
Recession outer tube 6, and keep the middle tube 5 and 4 position of internal layer guiding piece constant, until the outer layer branch
Frame 2 discharges；
Recession middle tube 5, is pushed forward the internal layer guiding piece 4, until the inner stent 1 discharges.
Specifically, bracket is loaded with transportation system together in advance in vitro, conveyed by transportation system along delivery conduit
To patient's body target position.Then drop back outer tube 6, at this time keep middle tube 5 and 4 position of internal layer guiding piece it is constant, then in
Position is constant at this time for second block piece 51 in layer pipe 5 outside, resists the tail end of outer stent 2, and the head end of outer stent 2 with
The recession of outer tube 6 constantly discharges, self-expanding, until all release in the blood vessels, convalescence swelling state.In the process,
Since the head end of inner stent 1 is fixedly connected with outer stent 2, the head end of inner stent 1 may have part release expansion.Then
Recession middle tube 5, discharges inner stent 1, for the position that inner stent 1 is accurately positioned, needs to be pushed forward in the process in described
Layer guiding piece 4, until the release completely of the inner stent 1 is in target position.The shape of inner stent 1 is by outer stent 2
Limitation, will not be released into shuttle shape or cryptomere；And the head end of inner stent 1 is fixedly connected with outer stent 2, is easier to precisely release
It puts.
It is not to be pushed forward the internal layer guiding piece 4 always, but before a specific time during discharging inner stent 1
It pushes away.Time and the assurance for being pushed forward distance, are means commonly used in the art, similar with the release process of close mesh stent.
When using outer tube 6 removably, bracket is loaded with transportation system together, by delivery system in advance in vitro
System is delivered in delivery conduit, withdraws from outer tube 6 at this time, and bracket, middle tube 5, internal layer guiding piece 4 are led along conveying together simultaneously
Pipe is delivered to target position, then passes through the cooperation of delivery conduit, middle tube 5, internal layer guiding piece 4, discharges branch in target position
Frame.
In the application, the head end of inner stent 1 or outer stent 2 refers to the one end (one far from patient for being introduced into blood vessel
End), tail end enters one end of blood vessel after referring to (close to one end of patient).And internal layer guiding piece 4, middle tube 5, outer tube 6
Front end refers to the one end (one end far from patient) for being introduced into blood vessel.Recession (such as recession outer tube 6) refers to outer tube 6 by remote
One end from patient is to close to the movement of one end of patient；It is pushed forward and (is such as pushed forward internal layer guiding piece 4) and refer to internal layer guiding piece 4 by leaning on
One end of nearly patient is mobile to one end far from patient.
Embodiment 1
As shown in Figs 1-4, a kind of bracket is provided, comprising: inner stent 1 is set in the outer layer in 1 outside of inner stent
Bracket 2, the inner stent 1 and outer stent 2 respectively include head end, tail end, and the interlude between head end and tail end；
The head end of the inner stent 1 is fixedly connected with the outer stent 2, forms bracket junction 3；
The inner stent 1 from it is swollen to blood vessel diameter when metal coverage rate > 15%, 2 self-expanding of outer stent
When to blood vessel diameter, when by axial force, the change rate < 15% of the axial each segment diameter of bracket.
The bracket junction 3 is located at the head end of the outer stent 2.
The bracket junction 3 is specially the loop connecting circle around 1 periphery of inner stent.
The head end of the outer stent 2 and the diameter of tail end, equal to the diameter of 2 interlude of outer stent.
The inner stent 1 is from swollen braided support, and the outer stent 2 is from swollen laser engraving bracket.
Embodiment 2
As seen in figs. 5-6, a kind of bracket is provided, comprising: inner stent 1 is set in the outer layer in 1 outside of inner stent
Bracket 2, the inner stent 1 and outer stent 2 respectively include head end, tail end, and the interlude between head end and tail end；
The head end of the inner stent 1 is fixedly connected with the outer stent 2, forms bracket junction 3；
The inner stent 1 from it is swollen to blood vessel diameter when metal coverage rate > 20%, the outer stent 2 self-expands into
When blood vessel diameter, when by axial force, the change rate < 10% of the axial each segment diameter of bracket.
The bracket junction 3 is located at the interlude of the outer stent 2.
The bracket junction 3 is specially the loop connecting circle around 1 periphery of inner stent.
The head end of the outer stent 2 and the diameter of tail end, greater than the diameter of 2 interlude of outer stent.
The inner stent 1 is from swollen braided support, and the outer stent 2 is from swollen laser engraving bracket.
Embodiment 3
Same as Example 1, only bracket junction 3 is specially 5 tie points around 1 periphery of inner stent.
Embodiment 4
As illustrated in figures 7-11, a kind of medical instrument is provided, is made of bracket and transportation system.
Wherein, the bracket is bracket documented by embodiment 1.
Transportation system includes: internal layer guiding piece 4, is set in the middle tube 5 in 4 outside of internal layer guiding piece, and is set in
The outer tube 6 in 5 outside of middle tube；
The inner stent 1 is loaded between the internal layer guiding piece 4 and the middle tube 5, and the outer stent 2 loads
Between the middle tube 5 and the outer tube 6；
4 outer wall of internal layer guiding piece is equipped with the first block piece 41, and first block piece 41 is located at the inner stent 1
Tail end, for stopping the movement of the inner stent 1；
5 outer wall of middle tube is equipped with the second block piece 51, and second block piece 51 is located at 2 tail of outer stent
End, for stopping the movement of the outer stent 2.
The front end of the middle tube 5, concordant with the tail end of the outer stent 2, second block piece 51 is located at described
The front end of middle tube 5.
The internal layer guiding piece 4 is conduit.
Embodiment 5
As shown in figs. 12-16, a kind of medical instrument is provided, is made of bracket and transportation system.
Wherein, the bracket is bracket documented by embodiment 2.
Transportation system includes: internal layer guiding piece 4, is set in the middle tube 5 in 4 outside of internal layer guiding piece, and is set in
The outer tube 6 in 5 outside of middle tube；
The inner stent 1 is loaded between the internal layer guiding piece 4 and the middle tube 5, and the outer stent 2 loads
Between the middle tube 5 and the outer tube 6；
4 outer wall of internal layer guiding piece is equipped with the first block piece 41, and first block piece 41 is located at the inner stent 1
Tail end, for stopping the movement of the inner stent 1；
5 outer wall of middle tube is equipped with the second block piece 51, and second block piece 51 is located at 2 tail of outer stent
End, for stopping the movement of the outer stent 2.
The front end of the middle tube 5, concordant with the tail end of the outer stent 2, second block piece 51 is located at described
The front end of middle tube 5.
The internal layer guiding piece 4 is conduit.
Embodiment 6
As shown in Figure 17-21, a kind of medical instrument is provided, is made of bracket and transportation system.
Wherein, the bracket is bracket documented by embodiment 2.
Transportation system includes: internal layer guiding piece 4, is set in the middle tube 5 in 4 outside of internal layer guiding piece, and is set in
The outer tube 6 in 5 outside of middle tube；
The inner stent 1 is loaded between the internal layer guiding piece 4 and the middle tube 5, and the outer stent 2 loads
Between the middle tube 5 and the outer tube 6；
The internal layer guiding piece 4 is located at 1 tail end of inner stent, for stopping the movement of the inner stent 1；
5 outer wall of middle tube is equipped with the second block piece 51, and second block piece 51 is located at 2 tail of outer stent
End, for stopping the movement of the outer stent 2.
The front end of the middle tube 5, concordant with the tail end of the outer stent 2, second block piece 51 is located at described
The front end of middle tube 5.
The internal layer guiding piece 4 is seal wire.
Shown outer tube 6 includes delivery conduit and loading pipe.
The foregoing description of the disclosed embodiments enables those skilled in the art to implement or use the present invention.
Various modifications to these embodiments will be readily apparent to those skilled in the art, as defined herein
General Principle can be realized in other embodiments without departing from the spirit or scope of the present invention.Therefore, of the invention
It is not intended to be limited to the embodiments shown herein, and is to fit to and the principles and novel features disclosed herein phase one
The widest scope of cause.
Claims (10)
1. a kind of bracket characterized by comprising inner stent (1), the outer layer branch being set on the outside of the inner stent (1)
Frame (2), the inner stent (1) and outer stent (2) respectively include head end, tail end, and between head end and tail end in
Between section；
The head end of the inner stent (1) is fixedly connected with the outer stent (2), is formed bracket junction (3)；
The inner stent (1) from it is swollen to blood vessel diameter when metal coverage rate > 15%, the outer stent (2) self-expands into
When blood vessel diameter, when by axial force, the change rate < 15% of the axial each segment diameter of bracket.
2. bracket according to claim 1, which is characterized in that the bracket junction (3) is located at the outer stent (2)
Head end, or be located at the outer stent (2) interlude.
3. bracket according to claim 1, which is characterized in that the bracket junction (3) is specially around the internal layer branch
The loop connecting circle of frame (1) periphery, or for around at least two linkage sections of the inner stent (1) periphery.
4. bracket according to any one of claim 1-3, which is characterized in that the head end of the outer stent (2) and/or
The diameter of tail end is greater than the diameter of the outer stent (2) interlude.
5. bracket according to any one of claim 1-3, which is characterized in that the different parts of the inner stent (1)
Metal coverage rate is different.
6. bracket according to any one of claim 1-3, which is characterized in that the inner stent (1) is from swollen volume
Knit bracket, the outer stent (2) is from swollen engraving bracket or from swollen braided support.
7. a kind of transportation system, for conveying bracket of any of claims 1-6 characterized by comprising internal layer
Guiding piece (4), the middle tube (5) being set on the outside of the internal layer guiding piece (4), and be set on the outside of the middle tube (5)
Outer tube (6)；
The inner stent (1) is loaded between the internal layer guiding piece (4) and the middle tube (5), the outer stent (2)
It is loaded between the middle tube (5) and the outer tube (6)；
The internal layer guiding piece (4) is located at the inner stent (1) tail end, for stopping the movement of the inner stent (1), or
Internal layer guiding piece (4) outer wall is equipped with the first block piece (41), and first block piece (41) is located at the inner stent (1)
Tail end, for stopping the movement of the inner stent (1)；
Middle tube (5) outer wall is equipped with the second block piece (51), and second block piece (51) is located at the outer stent (2)
Tail end, for stopping the movement of the outer stent (2).
8. transportation system according to claim 7, which is characterized in that the front end of the middle tube (5), with the outer layer branch
The tail end of frame (2) is concordant, and second block piece (51) is located at the front end of the middle tube (5)；The outer tube (6) is located at institute
State one section of reduced diameter before middle tube (5).
9. transportation system according to claim 7, which is characterized in that the internal layer guiding piece (4) is conduit or seal wire；
And/or
The outer tube (6) includes loading pipe and delivery conduit.
10. a kind of medical instrument, is made of bracket and transportation system, which is characterized in that the bracket is to appoint in claim 1-6
Bracket described in one, the transportation system are transportation system described in any one of claim 7-9.
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| CN201910816613.5A CN110507457B (en) | 2019-08-30 | 2019-08-30 | Support, conveying system thereof and medical instrument |
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| CN201910816613.5A CN110507457B (en) | 2019-08-30 | 2019-08-30 | Support, conveying system thereof and medical instrument |
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| CN110507457B (en) | 2022-04-22 |
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